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It is likely my husband will enter a nursing home within five years. I am the well-spouse and have been sole caregiver for six years now. Our last child just moved out of the house, and although I would love to down-size, I am not selling the house/downsizing due to the fact that Medicaid would treat any profit as assets which would need to be spent down. Our house is on two acres and with working 40+ hours a week and being my husbands's caregiver 24x7, I have very little time to keep up the house and lot. What would the Medicaid ramifications be of selling the house, getting something smaller, with less acreage, but not making a profit on the sale?

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Pam is correct about seeing an Elder Law Attorney.

Depending on your State Medicaid, maybe you could take half of the proceeds from the house to use for your new residence, and the other half be placed in a fund for your husband to use for his care. I would think you are entitled to one half of the house. That is something the Attorney can sort out.
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Thank-you again. Yes, my intentions are to down-size. So, if I understand this correctly, spending the profit from the sale of the house on private pay for husband's care is a qualified expense and would not create a penalty situation if he needs to qualify for Medicaid within 5 years. However, if he applies for Medicaid before all of the profit from the sale of the house has been spent on private pay, the remaining profit would be treated as an asset and would need to be spent down (assuming assets are above the allowable cap). This would probably never happen, as he wouldn't need to apply for Medicaid until the profit from the sale of the house was depleted anyway. Am I thinking about this correctly? Also, thanks for the warning about selling the house to create a loss. I am already in that situation in selling my car to my daughter at less than fair market value 3 years ago.
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I thought your intentions were to down size, in which case there would be something leftover to spend on his care. Whatever you do, do NOT sell the property at less than market value to create a loss. Medicaid will penalize you. You really should sit down with an Elder Law attorney and protect yourself from costly mistakes.
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Thanks for your answer pamstegma. In that case, where do I live? As the well-spouse, I will need a place to live and Medicaid allows me to keep the primary residence (up to a certain dollar limit).
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Sell the house and use the profits to get him into a facility as a private pay patient. You will have a lot nicer choices than waiting until it is all Medicaid.
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